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Preparing for a rheumatology appointment with palindromic rheumatism

The usual problem is that you walk in feeling fine, with normal-looking joints, to talk about something that was agony a fortnight ago. Preparation is mostly about closing that gap.

By Peter Barnett, who makes Aura · Updated 25 October 2026 · Not medical advice

Before the appointment

Write the summary first

Appointments are short. Lead with numbers a clinician can use straight away: "Nine attacks since March. Usually one joint, mostly the right hand and wrist, once the left knee. Each lasts one to two days, pain up to 8 out of 10, visible swelling about half the time." Then let them ask for the detail.

Gather the evidence of attacks

Palindromic rheumatism is diagnosed largely on the history of attacks, and the proposed criteria ask for at least one attack seen by a doctor.¹ If the doctor cannot see one, show one: photographs of the affected joint next to the unaffected side, with dates, are the next best thing.

If an attack starts before the appointment

In a 2025 interview study, people who saw a doctor during a flare tended to get referred sooner.² If you are waiting for a first referral, it can be worth trying to be seen while an attack is happening. If you already have a rheumatology team, ask at your appointment what they want you to do next time: call, send photos, or come in.

Note family history

Whether anyone in the family has rheumatoid arthritis, lupus, psoriasis or another autoimmune condition is often asked. It is easier to find out beforehand.

Questions worth asking

Pick the ones that matter to you. Write the answers down, or ask whether you can record the conversation.

• Do my blood tests (rheumatoid factor, anti-CCP) change what you expect to happen?
• What should I take during an attack, and when should I take it?
• Is there a treatment that could make attacks less frequent? What are its side effects, and what monitoring does it need?
• How long would it take to know whether a treatment is working?
• What would you want me to contact you about before my next appointment?
• What changes in my attacks would suggest the condition is changing?
• Is anything about my attacks unusual enough to look for other causes?
• When should I come back, and who do I contact in between?

People with palindromic rheumatism have said they did not feel confident they had been told all their treatment options.² "What else could we try?" is a reasonable question to ask.

After the appointment

• Write down the plan while you remember it: medicines, doses, tests, follow-up date.
• Keep logging. The next appointment will ask what changed, and the answer should be in your record rather than your memory.
• If you start a new medicine, note the start date in your diary so attacks before and after can be compared.

For background on the condition itself, see what palindromic rheumatism is and how it differs from rheumatoid arthritis.

This page is general information about preparing for an appointment. It is not medical advice, and decisions about your care belong with your clinician.